Swiss Catalogue of Learning Objectives for Undergraduate Medical Training

Under a mandate of the Joint Commission of the Swiss Medical Schools

4. Problems as Starting Points for Training

for definition see Chapter 2

... general symptoms

Objective ID

P 1   loss of blood^E

P 2   overweight / feeling too fat

P 3   loss of weight, emaciation

P 4   loss of appetite

P 5   malnutrition

P 6   fatigue

P 7   excessive daytime sleepiness (EDS)

P 8   general feeling of illness

P 9   enlarged lymph nodes (lymphadenopathy)

P 10   fever

P 11   fever in the immunocompromised host / recurrent fever

P 12   hypothermia^E

P 13   hyperthermia^E

P 14   abnormal perspiration

P 15   flushing

P 16   excessive thirst / excessive fluid intake (polydipsia)

P 17   dehydratation^E

P 18   unexpected, sudden death of unknown etiology and non-natural death^E

... metabolic alterations and abnormal laboratory values

Objective ID

P 19   hyperglycemia / diabetes mellitus

P 20   hypoglycemia

P 21   abnormal serum calcium / phosphate

P 22   abnormal pH of blood

P 23   abnormal serum lipids

P 24   abnormal liver function tests

P 25   abnormal serum potassium / magnesium

P 26   abnormal serum sodium

P 27   abnormalities of white blood cells

P 28   anemia

P 29   polycythemia / elevated hemoglobin

P 30   hypoxia, hypoxemia

P 31   hypercapnia / hypocapnia

P 32   proteinuria

P 33   renal failure

... skin manifestations

Objective ID

P 34   paleness

P 35   cyanosis

P 36   jaundice (icterus), including neonatal jaundice

P 37   acute swelling and/or changing color of body parts^E

P 38   skin inflammation

P 39   skin eruptions, skin rash

P 40   acne

P 41   boils

P 42   increased bleeding tendency (hemorrhagic diathesis)

P 43   itching

P 44   skin blisters

P 45   insect sting

P 46   wounds

P 47   burn / cold injury^E

P 48   electrical trauma^E

P 49   skin ulcers

P 50   mole (nevus)

P 51   change of skin pigmentation

P 52   skin tumors

P 53   excess hair (hirsutism)

P 54   lack of hair (alopecia) , excess loss of hair

P 55   abnormalities of the nails

... head, face, neck

Objective ID

P 56   headache, recurring / chronic

P 57   headache, sudden / new^E

P 58   facial pain

P 59   lack of / diminished facial movement

P 60   lockjaw (trismus)

P 61   trauma to the head including cerebral trauma^E

P 62   face injuries

P 63   toothache

P 64   neck pain

P 65   stiffness of neck

P 66   swelling in the neck

P 67   goiter

... ear, nose, mouth, tongue, throat, voice

Objective ID

P 68   ear ache

P 69   discharge from ear

P 70   loss of hearing, slow / sudden^E

P 71   ringing in the ears (tinnitus)

P 72   nose bleed (epistaxis)

P 73   nasal obstruction

P 74   nasal discharge

P 75   snoring

P 76   abnormalities of lips / tongue / mouth

P 77   increased secretion of saliva

P 78   dry mouth / dry throat

P 79   fetor oris (halitosis)

P 80   sore throat

P 81   problems with denture

P 82   alteration of voice (hoarseness / aphonia / dysphonia)

... eyes

Objective ID

P 83   slow loss of vision

P 84   sudden partial / temporary loss of vision / loss of visual field^E

P 85   squint (strabismus)

P 86   night-blindness

P 87   floating objects in the eye

P 88   light flashes (photopsia)

P 89   double vision (diplopia)

P 90   photophobia

P 91   acute eye pain / burning in the eye^E

P 92   foreign body / sandy feeling in the eye

P 93   itching eye

P 94   red eye

P 95   tearing eye

P 96   eye obscured by pus or mucus

P 97   blepharospasm

P 98   abnormal eye movements

P 99   abnormalities of pupils

P 100   exophthalmos (proptosis)

P 101   trauma to the eye^E

P 102   swollen eyes / swollen eyelids

... breast, chest, heart, blood pressure, pulse

Objective ID

P 103   breast: sense of weight / pain / tension

P 104   breast: change in size / outline / symmetry

P 105   gynecomastia

P 106   breast lump

P 107   breast: retracted skin / nipple

P 108   breast: discharging nipple, including galactorrhea

P 109   breast: eczema of nipple / areola

P 110   swollen axilla

P 111   wheezing respiration

P 112   dyspnea^E

P 113   apnea^E

P 114   increased respiratory frequency

P 115   painful respiration

P 116   cough

P 117   hemoptysis

P 118   tightness of the chest, chest discomfort

P 119   chest pain^E

P 120   chest trauma^E

P 121   pleural effusion

P 122   palpitations

P 123   irregular pulse / bradycardia / tachycardia^E

P 124   pulseless patient^E

P 125   high blood pressure

P 126   low blood pressure

P 127   vascular injuries

... abdomen, stomach, bowels

Objective ID

P 128   food intolerance

P 129   disorder of food passage, including dysphagia

P 130   regurgitation, belching of undigested food

P 131   swallowed foreign body

P 132   bloated abdomen / swollen sensation in abdomen

P 133   abdominal mass

P 134   abdominal trauma^E

P 135   heartburn (pyrosis)

P 136   epigastric pain

P 137   nausea / vomiting

P 138   abdominal pain^E

P 139   flatulence

P 140   diarrhea

P 141   constipation

P 142   hematemesis / melena^E

P 143   altered color or consistency of feces / blood / mucus / pus in feces

P 144   alteration of defecation pattern

P 145   painful defecation

P 146   fecal incontinence (encopresis)

P 147   rectal blood loss

P 148   anal itching / anal pain

... pelvic symptoms, urogenital problems

Objective ID

P 149   dysuria

P 150   disordered micturation

P 151   urinary incontinence (enuresis)

P 152   altered appearance of urine

P 153   loin pain^E

P 154   swelling in groin

P 155   scrotal pain^E

P 156   scrotal mass / swelling

P 157   urethral discharge

P 158   anomaly of male external genitalia

P 159   painful coitus (dyspareunia)

P 160   erectile / ejaculatory dysfunction

P 161   premenstrual syndrome

P 162   disorders of menstruation / of menstrual cycle

P 163   dysmenorrhea

P 164   pelvic pain

P 165   pelvic mass

P 166   uterine prolapse / pelvic relaxation

P 167   midcycle pain

P 168   vaginal bleeding: intermenstrual / postmenopausal / during pregnancy / post partum^E

P 169   vaginal discharge

P 170   abnormal female external genitalia

P 171   premature menopause

P 172   complaints related to the menopause, including flushing

P 173   request for contraception

P 174   request for delaying menstruation

P 175   suspicion of pregnancy

P 176   request for genetic counseling

P 177   request for abortion

P 178   infertile couple

P 179   high risk pregnancy

P 180   poor / excessive weight gain in pregnancy

P 181   fever during pregnancy

P 182   hypertension during pregnancy

P 183   abdominal pain during pregnancy

P 184   edema during pregnancy

P 185   lack of fetal movement

P 186   loss of amniotic fluid

P 187   premature labor

... bones, joints, back, extremities

Objective ID

P 188   acute pain in limbs^E

P 189   typical fractures: radius / scaphoid / finger / humerus / clavicle / vertebra / ribs / femur / pelvis / ankle

P 190   laceration, open wound

P 191   traumatic amputation of limb^E

P 192   wound with delayed healing or infection

P 193   contusion, soft tissue bruising

P 194   distortion of joint: ankle / hand

P 195   dislocation of joint: shoulder / finger

P 196   shoulder trauma

P 197   knee injury

P 198   trauma to the back including spinal cord trauma^E

P 199   polytrauma^E

P 200   swollen or painful joints

P 201   deformities of joints

P 202   morning stiffness

P 203   reduction of strength and/or joint motility

P 204   muscular pain (myalgia) / cramps

P 205   back pain

P 206   abnormal gait

P 207   abnormal posture

P 208   exercise-induced leg pain (claudication)

P 209   leg edema / generalized edema

P 210   leg ulcers

P 211   pain / burning / numbness in the feet

... newborn, child, adolescent

Objective ID

P 212   irritable / crying infant

P 213   hypotonic / floppy infant

P 214   diaper rash

P 215   problems with breast feeding

P 216   failure to thrive in infancy and childhood

P 217   refusal to eat / drink in infancy and childhood

P 218   enuresis / encopresis in infancy and childhood

P 219   limp / pain in lower extremity in children

P 220   motor / mental retardation / developmental delay in infancy and childhood

P 221   abnormal growth: slowing / acceleration

P 222   sudden infant death

P 223   precocious puberty / delayed puberty

P 224   hyperactive child

... elderly persons, aging

Objective ID

P 225   cognitive impairment in elderly person

P 226   elderly patient dependent in basic activities of daily living

P 227   falls in elderly person

P 228   failure to thrive and malnutrition in elderly person

P 229   hearing / vision impairment in elderly person

P 230   immobility, bedridden patient

P 231   mobility impairment in elderly person

P 232   pain in elderly person

P 233   polypharmacy in elderly person

P 234   sexual dysfunction in elderly person

P 235   sleep disorder in elderly person

P 236   social isolation in elderly person

P 237   urinary incontinence in elderly person

... disorders of consciousness, balance, orientation, gait, movement

Objective ID

P 238   dizziness / vertigo: acute / chronic^E

P 239   impairment / loss of consciousness, coma^E

P 240   falls

P 241   twitch, convulsion, seizure^E

P 242   acute paralysis, including hemiplegia^E

P 243   tingling (paresthesia)

P 244   change in sense of touch in the skin

P 245   abnormal involuntary movements: tremor / dyskinesia / tic disorders

... mental, behavioral and psychological problems

Objective ID

P 246   disorder of speech / of language

P 247   acute change in behavior / personality^E

P 248   obsessive-compulsive symptoms

P 249   aggressive and violent behavior towards others^E

P 250   autoaggressive behavior / risk of suicide^E

P 251   self-neglect

P 252   loss of initiative and interest

P 253   change in emotions and moods

P 254   nervousness / tension / anxiety / acute stress

P 255   agitation

P 256   confusion

P 257   forgetfulness, disorders of memory

P 258   disorder of attention and concentration

P 259   insomnia / sleep-wake cycle disturbances

P 260   abuse of alcohol

P 261   smoking, use of tobacco

P 262   abuse of medicines

P 263   illicit drug abuse and dependence

P 264   suspicion of poisoning^E

... other reasons for medical consultation or problems in medical care

Objective ID

P 265   infant and child immunization / periodic health examination for infants and children

P 266   request for check-up, health examination / for immunization

P 267   counseling / immunizations, before / after trip to foreign (tropical) country

P 268   pre-operative medical evaluation

P 269   request for medical certificate

P 270   psychological / physical / sexual abuse

P 271   fear of cancer / of heart disease / of HIV / of veneral disease / of other serious disease

P 272   terminal disease, the dying patient

... psychosocial and interpersonal problems

Objective ID

P 273   loss / death / illness of someone close

P 274   problems at work / concerning work conditions

P 275   absenteeism, non-attendance (school / work)

P 276   financial problems of patient / unemployment

P 277   problems in relationship with parents / partner / child

Objective ID
P 1	loss of blood^E
P 2	overweight / feeling too fat
P 3	loss of weight, emaciation
P 4	loss of appetite
P 5	malnutrition
P 6	fatigue
P 7	excessive daytime sleepiness (EDS)
P 8	general feeling of illness
P 9	enlarged lymph nodes (lymphadenopathy)
P 10	fever
P 11	fever in the immunocompromised host / recurrent fever
P 12	hypothermia^E
P 13	hyperthermia^E
P 14	abnormal perspiration
P 15	flushing
P 16	excessive thirst / excessive fluid intake (polydipsia)
P 17	dehydratation^E
P 18	unexpected, sudden death of unknown etiology and non-natural death^E

Objective ID
P 19	hyperglycemia / diabetes mellitus
P 20	hypoglycemia
P 21	abnormal serum calcium / phosphate
P 22	abnormal pH of blood
P 23	abnormal serum lipids
P 24	abnormal liver function tests
P 25	abnormal serum potassium / magnesium
P 26	abnormal serum sodium
P 27	abnormalities of white blood cells
P 28	anemia
P 29	polycythemia / elevated hemoglobin
P 30	hypoxia, hypoxemia
P 31	hypercapnia / hypocapnia
P 32	proteinuria
P 33	renal failure

Objective ID
P 34	paleness
P 35	cyanosis
P 36	jaundice (icterus), including neonatal jaundice
P 37	acute swelling and/or changing color of body parts^E
P 38	skin inflammation
P 39	skin eruptions, skin rash
P 40	acne
P 41	boils
P 42	increased bleeding tendency (hemorrhagic diathesis)
P 43	itching
P 44	skin blisters
P 45	insect sting
P 46	wounds
P 47	burn / cold injury^E
P 48	electrical trauma^E
P 49	skin ulcers
P 50	mole (nevus)
P 51	change of skin pigmentation
P 52	skin tumors
P 53	excess hair (hirsutism)
P 54	lack of hair (alopecia) , excess loss of hair
P 55	abnormalities of the nails

Objective ID
P 56	headache, recurring / chronic
P 57	headache, sudden / new^E
P 58	facial pain
P 59	lack of / diminished facial movement
P 60	lockjaw (trismus)
P 61	trauma to the head including cerebral trauma^E
P 62	face injuries
P 63	toothache
P 64	neck pain
P 65	stiffness of neck
P 66	swelling in the neck
P 67	goiter

Objective ID
P 68	ear ache
P 69	discharge from ear
P 70	loss of hearing, slow / sudden^E
P 71	ringing in the ears (tinnitus)
P 72	nose bleed (epistaxis)
P 73	nasal obstruction
P 74	nasal discharge
P 75	snoring
P 76	abnormalities of lips / tongue / mouth
P 77	increased secretion of saliva
P 78	dry mouth / dry throat
P 79	fetor oris (halitosis)
P 80	sore throat
P 81	problems with denture
P 82	alteration of voice (hoarseness / aphonia / dysphonia)

Objective ID
P 83	slow loss of vision
P 84	sudden partial / temporary loss of vision / loss of visual field^E
P 85	squint (strabismus)
P 86	night-blindness
P 87	floating objects in the eye
P 88	light flashes (photopsia)
P 89	double vision (diplopia)
P 90	photophobia
P 91	acute eye pain / burning in the eye^E
P 92	foreign body / sandy feeling in the eye
P 93	itching eye
P 94	red eye
P 95	tearing eye
P 96	eye obscured by pus or mucus
P 97	blepharospasm
P 98	abnormal eye movements
P 99	abnormalities of pupils
P 100	exophthalmos (proptosis)
P 101	trauma to the eye^E
P 102	swollen eyes / swollen eyelids

Objective ID
P 103	breast: sense of weight / pain / tension
P 104	breast: change in size / outline / symmetry
P 105	gynecomastia
P 106	breast lump
P 107	breast: retracted skin / nipple
P 108	breast: discharging nipple, including galactorrhea
P 109	breast: eczema of nipple / areola
P 110	swollen axilla
P 111	wheezing respiration
P 112	dyspnea^E
P 113	apnea^E
P 114	increased respiratory frequency
P 115	painful respiration
P 116	cough
P 117	hemoptysis
P 118	tightness of the chest, chest discomfort
P 119	chest pain^E
P 120	chest trauma^E
P 121	pleural effusion
P 122	palpitations
P 123	irregular pulse / bradycardia / tachycardia^E
P 124	pulseless patient^E
P 125	high blood pressure
P 126	low blood pressure
P 127	vascular injuries

Objective ID
P 128	food intolerance
P 129	disorder of food passage, including dysphagia
P 130	regurgitation, belching of undigested food
P 131	swallowed foreign body
P 132	bloated abdomen / swollen sensation in abdomen
P 133	abdominal mass
P 134	abdominal trauma^E
P 135	heartburn (pyrosis)
P 136	epigastric pain
P 137	nausea / vomiting
P 138	abdominal pain^E
P 139	flatulence
P 140	diarrhea
P 141	constipation
P 142	hematemesis / melena^E
P 143	altered color or consistency of feces / blood / mucus / pus in feces
P 144	alteration of defecation pattern
P 145	painful defecation
P 146	fecal incontinence (encopresis)
P 147	rectal blood loss
P 148	anal itching / anal pain

Objective ID
P 149	dysuria
P 150	disordered micturation
P 151	urinary incontinence (enuresis)
P 152	altered appearance of urine
P 153	loin pain^E
P 154	swelling in groin
P 155	scrotal pain^E
P 156	scrotal mass / swelling
P 157	urethral discharge
P 158	anomaly of male external genitalia
P 159	painful coitus (dyspareunia)
P 160	erectile / ejaculatory dysfunction
P 161	premenstrual syndrome
P 162	disorders of menstruation / of menstrual cycle
P 163	dysmenorrhea
P 164	pelvic pain
P 165	pelvic mass
P 166	uterine prolapse / pelvic relaxation
P 167	midcycle pain
P 168	vaginal bleeding: intermenstrual / postmenopausal / during pregnancy / post partum^E
P 169	vaginal discharge
P 170	abnormal female external genitalia
P 171	premature menopause
P 172	complaints related to the menopause, including flushing
P 173	request for contraception
P 174	request for delaying menstruation
P 175	suspicion of pregnancy
P 176	request for genetic counseling
P 177	request for abortion
P 178	infertile couple
P 179	high risk pregnancy
P 180	poor / excessive weight gain in pregnancy
P 181	fever during pregnancy
P 182	hypertension during pregnancy
P 183	abdominal pain during pregnancy
P 184	edema during pregnancy
P 185	lack of fetal movement
P 186	loss of amniotic fluid
P 187	premature labor

Objective ID
P 188	acute pain in limbs^E
P 189	typical fractures: radius / scaphoid / finger / humerus / clavicle / vertebra / ribs / femur / pelvis / ankle
P 190	laceration, open wound
P 191	traumatic amputation of limb^E
P 192	wound with delayed healing or infection
P 193	contusion, soft tissue bruising
P 194	distortion of joint: ankle / hand
P 195	dislocation of joint: shoulder / finger
P 196	shoulder trauma
P 197	knee injury
P 198	trauma to the back including spinal cord trauma^E
P 199	polytrauma^E
P 200	swollen or painful joints
P 201	deformities of joints
P 202	morning stiffness
P 203	reduction of strength and/or joint motility
P 204	muscular pain (myalgia) / cramps
P 205	back pain
P 206	abnormal gait
P 207	abnormal posture
P 208	exercise-induced leg pain (claudication)
P 209	leg edema / generalized edema
P 210	leg ulcers
P 211	pain / burning / numbness in the feet

Objective ID
P 212	irritable / crying infant
P 213	hypotonic / floppy infant
P 214	diaper rash
P 215	problems with breast feeding
P 216	failure to thrive in infancy and childhood
P 217	refusal to eat / drink in infancy and childhood
P 218	enuresis / encopresis in infancy and childhood
P 219	limp / pain in lower extremity in children
P 220	motor / mental retardation / developmental delay in infancy and childhood
P 221	abnormal growth: slowing / acceleration
P 222	sudden infant death
P 223	precocious puberty / delayed puberty
P 224	hyperactive child

Objective ID
P 225	cognitive impairment in elderly person
P 226	elderly patient dependent in basic activities of daily living
P 227	falls in elderly person
P 228	failure to thrive and malnutrition in elderly person
P 229	hearing / vision impairment in elderly person
P 230	immobility, bedridden patient
P 231	mobility impairment in elderly person
P 232	pain in elderly person
P 233	polypharmacy in elderly person
P 234	sexual dysfunction in elderly person
P 235	sleep disorder in elderly person
P 236	social isolation in elderly person
P 237	urinary incontinence in elderly person

Objective ID
P 238	dizziness / vertigo: acute / chronic^E
P 239	impairment / loss of consciousness, coma^E
P 240	falls
P 241	twitch, convulsion, seizure^E
P 242	acute paralysis, including hemiplegia^E
P 243	tingling (paresthesia)
P 244	change in sense of touch in the skin
P 245	abnormal involuntary movements: tremor / dyskinesia / tic disorders

Objective ID
P 246	disorder of speech / of language
P 247	acute change in behavior / personality^E
P 248	obsessive-compulsive symptoms
P 249	aggressive and violent behavior towards others^E
P 250	autoaggressive behavior / risk of suicide^E
P 251	self-neglect
P 252	loss of initiative and interest
P 253	change in emotions and moods
P 254	nervousness / tension / anxiety / acute stress
P 255	agitation
P 256	confusion
P 257	forgetfulness, disorders of memory
P 258	disorder of attention and concentration
P 259	insomnia / sleep-wake cycle disturbances
P 260	abuse of alcohol
P 261	smoking, use of tobacco
P 262	abuse of medicines
P 263	illicit drug abuse and dependence
P 264	suspicion of poisoning^E

Objective ID
P 265	infant and child immunization / periodic health examination for infants and children
P 266	request for check-up, health examination / for immunization
P 267	counseling / immunizations, before / after trip to foreign (tropical) country
P 268	pre-operative medical evaluation
P 269	request for medical certificate
P 270	psychological / physical / sexual abuse
P 271	fear of cancer / of heart disease / of HIV / of veneral disease / of other serious disease
P 272	terminal disease, the dying patient

Objective ID
P 273	loss / death / illness of someone close
P 274	problems at work / concerning work conditions
P 275	absenteeism, non-attendance (school / work)
P 276	financial problems of patient / unemployment
P 277	problems in relationship with parents / partner / child